title: Head-shaking nystagmus: a sensitive indicator of vestibular dysfunction.
abstract: This study investigated 258 consecutive patients with the complaint of vertigo undergoing vestibular function tests between August 1992 and July 1994. The head-shaking nystagmus test was performed in a passive fashion with the patient placed in a sitting position with the head anteflexed at 30 degrees and oscillated +/- 45 degrees horizontally for 30 cycles in 15 s; the post head-shaking nystagmus was recorded by electronystagmography. Conventional bithermal caloric tests were conducted with the normal limit of canal paresis set at 20%. The results show significant correlation between head-shaking nystagmus and canal paresis. Head-shaking nystagmus is more sensitive than canal paresis in predicting vestibular dysfunction. The sensitivity of head-shaking nystagmus in detecting a canal paresis was 90%. Although the direction of head-shaking nystagmus does not always accord with the side of peripheral vestibular dysfunction, it is an indicator of vestibular dysfunction and this test could be performed easily as a screening test in every otoneurological investigation.
authors.affiliation: Department of Otolaryngology, National Cheng Kung University Hospital, Tainan, Taiwan.
authors.forename: H Z
authors.initials: HZ
authors.lastname: Tseng
authors.forename: W Y
authors.initials: WY
authors.lastname: Chao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004584:Electronystagmography; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009760:Nystagmus, Physiologic / Q000502:physiology*; D012680:Sensitivity and Specificity; D014717:Vertigo / Q000175:diagnosis; D015837:Vestibular Diseases / Q000175:diagnosis*; D014724:Vestibular Function Tests / Q000379:methods*